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Use of high-dose methylprednisolone pulse therapy in patients with progressive and stable vitiligo


Uwe Reinhold, md , Department of Dermatology, The Saarland University Hospital, 66421 Homburg/Saar, Germany



Background  Although there are several treatment options available for patients with generalized vitiligo, their efficacy is still a matter of debate. Although shown to be effective, corticosteroids applied either systemically or topically carry the risk of significant side-effects in long-term therapy. We evaluated the effectiveness of intravenous methylprednisolone (8 mg/kg body weight) administered on three consecutive days in patients with generalized vitiligo.

Materials and methods  A total of 14 patients with progressive or static vitiligo were included in a prospective, open, clinical study.

Results  Eighty-five per cent of the patients presenting with progressive disease showed cessation of disease progression after the infusion therapy. Repigmentation was observed in 71% of patients with progressive vitiligo. None of the six patients presenting with static disease showed any repigmentation in response to this form of treatment. The therapy was well tolerated in all but one patient who developed intermittent arterial hypertension during therapy.

Conclusions  High-dose glucocorticoid pulse therapy may represent a therapeutic option in patients with generalized progressive vitiligo, and should be further evaluated in a prospective, randomized, clinical trial.